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Biomedical subjects

E C Morrison

Publications and source records attributed to E C Morrison.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effects of metronidazole on periodontal treatment needs.

Periodontitis, a common cause of tooth loss in adult populations, is an inflammatory response to the overgrowth of anaerobic organisms such as spirochetes and bacteroides and, in some cases, micro-aerophilic organisms in the subgingival plaque. In the present investigation, using a double-blind clinical design, we sought to determine whether 1 week of metronidazole treatment plus debridement of the tooth surfaces was superior to 1 week of placebo treatment plus debridement (positive control) in reducing the subsequent amount of periodontal surgery given to the patients. Thirty-nine patients were randomly assigned to either the metronidazole or placebo (positive control) groups. All patients were given the necessary scaling and root planing and were unsupervised in their usage of the medication. After the completion of this treatment, they were reexamined and it was found that the metronidazole regimen caused a significant reduction in surgical needs of about 5 teeth per patient compared to the positive control (difference before and after treatment 8.3 +/- 6.8 teeth metronidazole versus 2.9 +/- 4.8 positive control, P = 0.007). The difference between groups was maintained during the 2 to 3 years' recall period. Metronidazole had a significant effect on the site specific reduction of spirochetes: 90% of the sites in the metronidazole group versus 64% in the positive-control group had a decrease in the percentage of spirochetes (P less than 0.05). We conclude that systemic metronidazole given 250 mg tid for 7 days in conjunction with debridement of the tooth surfaces can significantly reduce the need for periodontal surgery compared to the standard regimen which included only debridement.

Alveolar Bone Loss↗
PubMed1990

Natural history of periodontal disease in adults: findings from the Tecumseh Periodontal Disease Study, 1959-87.

The purpose of this epidemiological study was to estimate the degree of change in periodontal attachment level in a sample of adults examined in 1959 and 1987 in Tecumseh, Michigan. Out of 526 individuals between the ages of five and 60 years in 1959, a sample of 325 resided within an 80-km-radius area in 1987. Of those, 167 were re-examined. Loss of periodontal attachment (LPA) was determined with a Michigan #0 probe on four tooth sites (disto-buccal, mid-buccal, mesio-buccal, mid-lingual) for all teeth present. Of the individuals contacted, 28 had lost all their teeth during the 28 years. Of the 167 adults examined, two refused periodontal probing. Out of the 165 adults with LPA measurements in 1987, only 22 (13.3%) had an average increased loss of 2 mm or more per person between 1959 and 1987; five adults (3.0%) had an average LPA increase of 3 mm or more, and only two adults (1.2%) had an average LPA increase of 4 mm or more. The attachment level in 59.3% of all the tooth sites examined in 1959 in the 165 individuals either did not change or changed within +/- 1.0 mm. On the basis of bivariate analyses, the individuals with high LPA increase (greater than or equal to 2 mm) had the following characteristics significantly different from those with low LPA increase: They were older, smoked, had tooth mobility at baseline, higher gingivitis, plaque, calculus, and tooth mobility scores at follow-up, lower education level, and irregular dental attendance.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1990

Risk factors for tooth loss over a 28-year period.

Over 500 residents of Tecumseh, Michigan, were dentially examined in 1959 as part of a community-wide health study. In 1987, the dental examinations were repeated, with use of the same criteria as in 1959, for 167 dentate persons from the original group. Another 28 reported by telephone that they had become edentulous since 1959. This report uses a historical cohort analysis for exploration of the risk factors for tooth loss, both total and partial, over the 28-year period. Over that time, the edentulous lost an average of 18.0 teeth (95% confidence interval 15.5, 20.7), whereas the age-matched 90 dentate persons lost only 3.2 (2.2, 4.2) teeth each. Descriptive data showed the edentulous to have higher baseline scores for plaque, calculus, and gingivitis, and a higher proportion of them smoked, though only loss of periodontal attachment (LPA) of 4 mm or more, early loss of first molars, and educational attainment were significant risk factors in regression analysis. Odds ratios for these three variables were 4.0 (1.2, 12.8), 2.0 (1.3, 3.1), and 0.6 (0.4, 0.9), respectively. The strongest risk factors for partial tooth loss among 116 dentate persons were baseline gingivitis (which was correlated with LPA of 4 mm or more) and the baseline number of teeth present, with odds ratios of 2.4 (1.2, 5.2) and 0.8 (0.7, 1.0), respectively. While the analysis had to be carried out without caries data, it was concluded that total tooth loss is a social-behavioral issue as much as it is disease-related. Social-behavioral factors were less clearly related to partial tooth loss in dentate persons; oral disease characteristics were the most prominent risk factors for partial tooth loss.

Cohort Studies↗
PubMed1990

Furcation defects in dogs treated by guided tissue regeneration (GTR).

This study evaluated the effects of guided tissue regeneration (GTR) in the treatment of Class II furcation defects in beagle dogs. Gore-Tex periodontal material was used, and the amount of furcation fill and the surface area corresponding to new connective tissue attachment and new bone were evaluated. If present, epithelium was also evaluated. Six female dogs with naturally-occurring periodontitis were given thorough root debridement. Four weeks later mucoperiosteal flaps were raised, involving the mandibular 2nd, 3rd, and 4th premolar and 1st molar teeth. After debridement, notches were placed on the roots at the level of furcal alveolar bone. Gore-Tex material was adapted to the furcation and secured with sutures on two teeth of each quadrant. The flaps were sutured tightly, making sure the margin of the material was covered. Teeth receiving only surgery acted as controls. Gore-Tex material was removed 1 month following surgery. All dogs were sacrificed by exsanguination at 3 months. Mesiodistal sections were evaluated by descriptive histology. Surface area determination of the furcal tissues was carried out using a microscope attached to a computerized digitizer. Approximately 10 serial sections per tooth were evaluated. Mean values for each dog were obtained for experimental and control teeth and analyzed using paired t-tests (N = 6) to see whether different treatments had any effect on the parameters tested. Different degrees of fill were seen with epithelium, new connective tissue, and bone. Statistically, GTR gave significantly better results in the amount of connective tissue and bone fill achieved.

Alveolar Process↗
PubMed1990

Class II furcations treated by guided tissue regeneration in humans: case reports.

In the cases reported here, the response of Class II mandibular molar furcation defects to guided tissue regeneration (GTR) versus sham operation was evaluated. Base-line information, including probing pocket depth (PD) and clinical attachment level (CAL) measurements, was recorded after completion of the hygienic phase. Eleven experimental and six control furcations, randomly assigned, are included in this report. The furcations were surgically exposed, using a flap approach and the areas were debrided. On the experimental teeth, Gore-Tex periodontal material was adapted and sutured, using a suspensory suture. The flaps were then sutured tightly, assuring complete coverage to the material. For 1 month all patients were seen weekly and rinsed their mouths with an 0.12% chlorhexidine solution daily. After 4 to 6 weeks the Gore-Tex membranes were removed. Clinical measurements were repeated at 3 and 6 months following surgery. Changes from baseline in PD and CAL were calculated for each case. Results indicated that PD measurements were reduced by both procedures, but the reduction was better for GTR at 3 and 6 months. At six months the test sites showed 2.8 +/- 1.0 mm pocket reduction, while the control sites showed an average of 1.6 +/- 0.9 mm reduction in pocket depth. CAL recordings were improved by both treatments, but were better for GTR at 6 months, with an average gain in CAL of 1.8 mm for the GTR and 0.6 mm for the controls. These cases in which GTR was compared to sham-operated controls indicate that GTR can improve the response to therapy of Class II furcation defects.

Adult↗
PubMed1990

Diagnostic discrimination of bleeding on probing during maintenance periodontal therapy.

The purpose of this study was to test the diagnostic discrimination of bleeding on probing in a group of 71 patients who have been treated for periodontitis. They have been maintained over 5 years receiving prophylaxis every 3 months and clinical evaluation once a year. 1,746 teeth were used and extracted and retreated teeth were not included. The presence or absence of bleeding on probing was recorded for each tooth over the five yearly examinations. After recording the site variations between the 1st and the 5th year maintenance values, the highest value of attachment loss per tooth was selected. Teeth were considered diseased when they presented at least one site with 4 mm of probing pocket depth at the baseline (year 1) and 2 mm of attachment loss after 5 years (Criterion 1), or showed 3 mm of attachment loss after 5 years (Criterion 2). The prevalence of disease was 8.19% (143 teeth) for Criterion 1 and 19.7% (344 teeth) for Criterion 2. Bleeding on probing 2 times presented the highest sensitivity (86% Criterion 1 and 64.5% Criterion 2) and the lowest predictability (11.9% Criterion 1 and 21.4% Criterion 2). Bleeding on probing frequency = 5 times showed the highest specificity (93.6% Criterion 1 and 93.4% Criterion 2) and predictability (93.4% Criterion 1 and 81.5% Criterion 2). These results demonstrated that bleeding on probing may not be substituted for clinical attachment levels when evaluating the periodontal attachment loss over time. However, the high specificity and predictability of these tests as a negative one suggests that absence of bleeding after probing may be a good indicator of maintenance of periodontal attachment levels over time.

Epithelial Attachment↗
PubMed1988

The effects of periodontal therapy on serum antibody (IgG) levels to plaque microorganisms.

The influence of periodontal therapy on serum antibody titers to selected periodontal disease-associated microorganisms was assessed in 23 patients having chronic inflammatory periodontal disease (CIPD). The immunoglobulin G (IgG) titers were determined by the microELISA technique in serum samples obtained prior to treatment; following a hygienic phase which included scaling, root planing, and oral hygiene instruction; following surgical treatment; and one year and two years following hygienic phase (maintenance phase). Considerable individual variability existed in the magnitude of immune response to specific bacterial preparations. Significant reductions in the mean antibody titers were seen to A. viscosus, S. sanguis, F. nucleatum, S. sputigena, B. gingivalis, B. intermedius, B. melaninogenicus, T. vincentii, and T. denticola by the end of the second year of maintenance. There was no consistent response to Capnocytophaga. When individual patient responses were examined, 6 of the 23 were found to have elevated titers to at least one of the microorganisms in the interval between pretreatment and the end of the hygienic phase; however, in all but one case, the titers at the end of the second year of maintenance were below pretreatment levels. Antibody levels to bacteria such as S. sanguis were modified during therapy. This would indicate that immune responses to microbes not generally considered to be "periodontal pathogens" may be modified by adjuvant activity associated with subgingival plaque or changes in the environment of the sulcus and that subsequent changes in titer do not necessarily reflect a role of that microorganism in the disease process.

Adult↗
PubMed1988

A longitudinal study comparing scaling, osseous surgery and modified Widman procedures. Results after one year.

The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1-3 mm) were reduced when compared to posthygiene. Four- to six-millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets greater than 7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1-3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4-6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with greater than 7 mm. Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1-3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4-6 mm and greater than 7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three-month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth.

Adult↗
PubMed1988

Clinical evaluation of the use of citric acid and autologous fibronectin in periodontal surgery.

This study evaluated the effects of citric acid demineralization and autologous fibronectin application in association with a modified Widman flap in the treatment of periodontitis. The study population comprised 29 patients under treatment for moderate to advanced periodontitis who reached the one-year posttherapy evaluation. After thorough scaling and root planing, a split mouth design was used in which two quadrants were treated by modified Widman flap alone, and the other two randomly assigned quadrants were treated by modified Widman flap combined with citric acid demineralization and autologous fibronectin application. Fibronectin, which had previously been isolated from the patient's own plasma, was applied with a tuberculin syringe on the citric acid demineralized root surfaces and the inner aspect of the flap. After suturing provided good flap adaptation, additional fibronectin was again applied under the flap and external pressure was applied. Patients were clinically evaluated at baseline and at one year. Statistical evaluation of the data using paired t test and Chi-square analysis indicated that both approaches, modified Widman flap alone or in combination with citric acid and fibronectin, significantly reduced probing pocket depth and increased clinical attachment. However, the changes achieved with citric acid and fibronectin were statistically greater than those obtained with the flap alone. Furthermore, the number of sites gaining 2 mm or more of clinical attachment were significantly increased. The results suggest that the use of citric acid and fibronectin holds promise in promoting reattachment after periodontal therapy.

Adult↗
PubMed1987

4 modalities of periodontal treatment compared over 5 years.

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and rool planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment greater than or equal to 2 mm and greater than or equal to 3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4-6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures.

Clinical Trials as Topic↗
PubMed1986

In vitro polishing effectiveness of interdental aids on root surfaces.

The purpose of this study was: to determine whether polishing standardized proximal root surfaces with dental floss, Superfloss, wood and plastic interdental cleaners, using a polishing paste, produces any significant change on root surface roughness; and to determine the effectiveness of different number of strokes in polishing. 80 tooth specimens were prepared, 10 in each of 8 sample groups. Each proximal root surface was standardized with 600A grit silicone carbide paper and polished with either waxed dental floss, Superfloss, wood or plastic interdental cleaners, using alkali aluminum silicate polishing paste. All specimens were mounted on a flossing machine and polished with 10 or 20 strokes. Before and after polishing, measurements were recorded with the Surfanalyzer 150 System to produce profile and average roughness tracings. Average maximum peak heights, mean number of peaks, and mean average roughness values were calculated from the tracings. The data were analyzed statistically by paired t-test and Student t-test. No significant mean differences were found between the number of strokes used. No significant differences were found for waxed dental floss in relation to the values analyzed. Significant differences were found for maximum peak heights for Superfloss following 20 strokes of polishing. However, no significant differences were found for Superfloss for mean number of peaks and average roughness. Significant differences were found for average roughness values, maximum peak heights, and mean number of peaks for the wood and plastic interdental cleaners. It was concluded that root surface roughness increased significantly with the use of wood and plastic interdental cleaners but not with waxed dental floss or Superfloss.

Carbon↗
PubMed1986

The effectiveness of citric acid as an adjunct to surgical re-attachment procedures in humans.

The purpose of this study was to clinically evaluate the effect of citric acid on re-attachment and re-adaptation in conjunction with periodontal surgery. A split-mouth design was used in 10 patients involving 30 quadrants of surgery. A total of 120 teeth were treated. Each quadrant consisted of at least 2 teeth from cuspid to second molar. One quadrant was treated with a modified Widman flap alone while the root surfaces of the contralateral side were also treated with a 3 min application of citric acid. Immediately following hygienic phase and at 3 and 6 months postsurgically, the following measurements were taken in this sequence: gingival index, gingival crevicular fluid flow, plaque index, furcation involvement, level of attachment and probing depth. All the data were statistically analyzed using the paired t-test, chi 2 and Fisher exact probability test. The biometric results showed that both surgical techniques resulted in a loss of attachment in shallow pockets and a gain in deeper pockets. Both techniques resulted in similar amounts of recession and probing depth reduction at 6 months. Gingival index, plaque index and furcation values decreased at 3 and 6 months postsurgically. The gingival crevicular fluid values remained essentially the same up to 6 months postsurgically.

Adult↗
PubMed1985

The therapeutic effect of toothbrushing on naturally occurring gingivitis.

A majority of previous toothbrushing studies have examined proposed virtues of particular brushing techniques or the relative cleaning ability of various toothbrushes. A smaller number were concerned with their role in prevention of gingivitis. Whether toothbrushing could be therapeutic in naturally occurring gingivitis was tested in 40 teenagers aged 12 to 14 years. Groups from two public schools were examined for gingivitis and plaque. Students from both groups were given a soft multi-tufted toothbrush and nonfluoridated toothpaste to be used daily. Students at one school were given a single intensive oral hygiene session. All students were reexamined 42 days later and given a thorough prophylaxis. Final readings were obtained 84 days after baseline and the results analyzed statistically. Sign test analysis disclosed a significant (P less than .01) improvement in plaque and gingivitis scores for both groups. Wilcoxon tests of patient means revealed a significant improvement in plaque scores, whereas gingivitis means were more variable. Chi square analysis between groups showed that the groups receiving oral hygiene instructions had significantly better (P less than .01) plaque and gingivitis scores at session 2. Gingivitis differences were generally significant at session 3. Toothbrushing has a therapeutic effect on naturally occurring gingivitis, enhanced by oral hygiene instruction.

Adolescent↗
PubMed1985

Bacterial profiles of subgingival plaques in periodontitis.

In this report over 400 subgingival plaque samples taken from over 110 patients were examined microscopically and culturally for 30 bacterial parameters. The patients could be placed into six disease categories based upon clinical criteria. The bacterial profile of each clinical category was generally distinctive of that category. Periodontal patients who had been successfully treated and maintained had plaques that were populated by significantly higher proportions of Streptococcus sanguis, Actinomyces viscosus, A. odontolyticus and S. mutans and significantly lower proportions of B. gingivalis and spirochetes compared to the five untreated disease categories. The spirochetes were the overwhelming microbial type in the plaques of adult periodontitis (AP) patients, averaging about 45% of the microscopic count. The bacteriological results could not distinguish between ADA Type III and IV periodontitis, suggesting that the same type of infection was occurring in an active site in any AP patient. The patients designated as early onset periodontitis (EOP) differed from the other patients by their relative youth and by their significantly higher proportions of Bacteroides gingivalis and/or B. intermedius. Two types of EOP were recognized in which the most diseased variant was characterized by having an average of 49% spirochetes in the plaque. Four localized juvenile periodontitis (LJP) patients were notable in not having detectable A. actinomycetemcomitans. The data indicate that the various types of periodontitis, with the possible exception of LJP are specific anaerobic infections involving spirochetes and to a lesser extent B. gingivalis and B. intermedius.

Actinomyces↗